Finchgorman6064

and STATAv15.Results Relative incidence of SCC, BCC and lip cancer was significantly elevated with every use of HCTZ. Relative incidence of melanoma and oral cancer was not significantly elevated with HCTZ exposure. Smoking was inversely associated with BCC and melanoma risk, but significantly increased the risk of lip and oral cavity cancers. SCC risk was not strongly associated with smoking. Significantly reduced risk of SCC, BCC melanoma and oral cavity cancer was associated with a BMI ≥30 kg/m2.Conclusions The risk of NMSC and lip cancer in a UK population is increased with cumulative high-dose HCTZ exposure. It is therefore important for dentists to note as it may increase suspicion of lesions in patients taking these medications.Data sources In this systematic review and meta-analysis, Medline, Scopus and Web of Science databases were searched using Medical Subject Headings (MeSH) to identify studies assessing the risk of malignant transformation in oral lichen planus (OLP).Study selection Observational studies published in English between 2003-2020 were independently assessed for inclusion by two blinded investigators.Data extraction and synthesis Data were extracted independently by two investigators followed by discussion to reach consensus. This included study design and patient characteristics; length of follow-up; risk of bias; method of OLP diagnosis; oral squamous cell carcinoma (OSCC) risk factors; rate of malignant transformation; and individual characteristics of malignant transformation cases. Cases of malignant transformation in the included studies were only included in meta-analysis if 1) OLP diagnosis met current diagnostic criteria; 2) OSCC developed in the same site as previously diagnosed OLP after at least six mons female. Random-effects meta-analysis estimated an OLP malignant transformation rate of 0.2% (95%CI 0.1-0.3%). Heterogeneity was low (I2 = 28.74%, p = 0.065). Malignant transformation was significantly higher among smokers (OR = 4.62, p = 0.001), alcohol consumers (OR = 3.22, p = 0.05), those with hepatitis C (OR = 3.77, p = 0.03) and atrophic or erosive OLP subtypes (OR = 2.70, p = 0.03). Gender was not associated with increased risk of malignant transformation.Conclusions The malignant transformation rate of OLP is likely to be lower than previously reported, possibly as a result of variable diagnostic criteria. Whilst encouraging, clinical vigilance remains necessary, as OLP does carry a small risk of malignant transformation. Smoking, alcohol use, hepatitis C infection and erosive or atrophic subtypes appear to have a greater rate of malignant transformation.Design A systematic review and bivariate meta-analysis was designed to determine the efficacy of toluidine blue (TB) in the screening and diagnosis of oral cancer and premalignant lesions. Six databases were reviewed independently by two authors to identify relevant studies.Case selection Inclusion criteria comprised prospective or retrospective studies comparing TB with chemiluminescence or clinical examination, which incorporated sensitivity and specificity analyses. Studies regarding diagnosis of non-oral tumours were excluded, as well as case reports and review articles.Data analysis Diagnostic accuracy was analysed using diagnostic odds ratio (DOR) with 95% confidence intervals (CI). Summary receiver operating characteristic (SROC) curves and the inter-rater agreement were also analysed. Cohen's kappa coefficient and Fisher z-values were used to estimate reliability and stabilise variance. Homogeneity analyses were performed using the Q statistic. Forest plots were drawn for the sensitivity, specificity, negative predictive values, and SROC curves.Results Twenty-nine studies comprising 1,921 participants were included in the meta-analysis. The DOR of TB was 7.017 (95% CI, 4.544; 10.836). Nine studies compared TB with chemiluminescence; TB had a lower sensitivity but a higher specificity. Compared with clinical examination in four studies, TB had a higher sensitivity and specificity. TB has a sensitivity of 73% and specificity of 69%, and was found to be more sensitive in severe dysplasia but more specific in benign lesions.Conclusions The diagnostic accuracy of TB for oral cancer or premalignant lesions is greater than clinical examination alone; however, it is not reliable enough for TB to be used as a screening method in isolation. TB is a diagnostic aid that can be recommended in adjunct with chemiluminescence or other techniques.Aim To determine the accuracy of using saliva and oral cytology swabs in the diagnosis of oral squamous cell carcinoma (OSCC) by detecting aberrantly hypermethylated DNA.Data sources Electronic databases including PubMed/Medline, Embase, Cochrane Library, Scopus and Web of Science with no language or article restrictions. Additionally, LILACS database, OpenGrey and Google Scholar were searched.Study selection Studies published since the first report proposing DNA hypermethylation for head and neck carcinomas in 2001 until 2020 were included. The diagnoses of oral cancer were limited to OSCC. Authors screened titles and abstracts for relevance, before further screening of full texts and a consensus for inclusion was reached. Qualitative analysis was conducted on 22 studies, and 11 were selected for meta-analysis.Data analysis Diagnostic test accuracy meta-analysis was performed using a series of investigations including the Haldane-Anscombe correction, forest plots, receiver operator characteristic (ROC) curveylation rates.Conclusion Hypermethylation markers using saliva and oral swabs are more specific than sensitive for OSCC diagnosis. Combining different genes within the biomarker panel can improve diagnostic test accuracy. However, more blinded evaluation study designs with less bias which replicate real-world application are required to endorse the use of saliva sampling and oral swabs in oral oncology.Data sources Four electronic databases were searched Medline (OVID), Web of Science, Embase and Scopus. An initial search was carried out in May 2018, and this was updated in September 2020. There was no time restriction on the studies included, and the final data consisted of studies published from 2004-2020.Study selection The electronic database search yielded 2,764 abstracts, and following de-duplication, 1,873 articles were screened in accordance with the exclusion criteria. In total, 346 articles were selected for full-text screening by four pairs of blinded reviewers and 295 articles were included in the final study. The main objectives of this study were to investigate a suitable biomarker for early detection of oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMDs), and to assess the relationships between salivary biomarkers and risk factors for OSCC and OPMD. The Newcastle-Ottawa Scale was used for quality assessment. Most studies were considered to have a moderate riskL1β, IL6 and IL8 were identified as being statistically significant and most suitable for early identification of OSCC and OPMDs. In smokers, there were significant differences found in certain biomarkers compared to controls. There were statistically non-significant relationships found between biomarkers and alcohol, as well as other risk factors.Conclusion The authors proposed that a proteomic salivary biomarker panel, including a combination of IL1β, IL6 and IL8, would be suitable for clinical validation for the early detection and screening of OPMDs and OSCC. They have also highlighted the presence of research gaps in the relationship between salivary biomarkers and risk factors for OPMDs and OSCC, and the need for further research to understand the role of biomarkers in disease initiation and progression.Design Systematic review.Case selection This study had a focused research format in terms of PICO (Population, Intervention, Comparison, Outcomes). There were no age, gender or medical conditions which restricted or excluded patients from the inclusion criteria. The intervention was the use of alcohol-based mouthwashes in comparison to the control group where no mouthwash was used. A literature search was carried out utilising three electronic databases including PubMed, Scopus and Cochrane Library. The papers included for analysis within this review were all published from 2006 onwards and animal studies, case series and case reports were excluded.Data analysis The qualitative analysis included 43,499 participants from eight papers which included two meta-analyses, one clinical trial, three case-control studies and two cohort studies, all of which fulfilled the inclusion criteria. Data were analysed by two independent reviewers who initially screened the articles and removed duplications before a second rounontaining mouthwashes alone (when no other risk factors are present) does not increase the risk of developing an oral cancer or lead to increased salivary acetaldehyde. However, where other risk factors for oral cancer are present, the use of an alcohol-based mouthwash may further increase this risk.Design The study was a systematic review and meta-analysis conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement and the guidelines from the Cochrane handbook for systematic reviews of interventions.Data sources Literature searches of free text and MeSH terms were performed using Medline (PubMed), Scopus, Google Scholar and the Cochrane Library (from 2000 to 30 June 2020). The search strategy was ("oral screening devices" or "autofluorescence" or "chemiluminescence" or "optical imaging" or "imaging technique") and ("oral dysplasia" or "oral malignant lesions" or "oral precancerosis").Data analysis After identification of 1,282 potential articles, an analysis applying the eligibility criteria to the research identified 43 articles for qualitative evaluation and 34 for quantitative analysis.Results The results presented were inconsistent, both in the whole and in technique groups. There was evidence of high risk of bias in the evaluated studies. Moreover, the results were homogeneous across studies, which makes it challenging to carry out a reliable comparison of measures like specificity or positive/negative predictive values.Conclusions Imaging-based techniques for early diagnosis of potentially malignant oral lesions must improve technology and accuracy. In addition, none of the evaluated methods can substitute the oral biopsy.Background Oral potentially malignant disorders (OPMDs) include erythroplakia, erosive lichen planus, non-homogenous leukoplakia and many others. These lesions may revert to healthy tissues, remain unchanged, or undergo malignant change to oral squamous cell carcinoma (OSCC). Early detection allows early management, which subsequently improves survival rates for OSCC. Current diagnostic practice involves a tissue biopsy with histology. This can be uncomfortable for patients and delays diagnosis. Other, less invasive diagnostic tests are available which can provide immediate results.Objectives Primary objective to evaluate the diagnostic accuracy of index tests in detecting OSCC and OPMDs. Secondary objective to determine the relative accuracy of alternative diagnostic tests.Search methods Four online databases including Medline (OVID), Embase (OVID), the US National Institute of Health Ongoing Trials Register (clinicaltrials.gov) and the World Health Organisation International Clinical Trials Registry Platform were searched for ongoing trials to 20 October 2020.